Terre Haute Boys & Girls Club : Programs : Program Information : Fall Break

The Terre Haute Boys & Girls Club will be open for current members Friday, October 9th and Monday, October 12th from 8:30 AM - 5:30 PM. The fee is $10.00 per child per day. Lunch not included. We will provide a 10:00 snack and a dinner meal at 5:00.

Current September 1, 2020 - August 31, 2021 Membership Required. Memberships are available under our program tab pull down at the top of every page.

Child's Name

First Name

Last Name

Grade Fall 2020 (Required)

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School Fall 2020 (Required)

Age (Required)

Gender (Required)

Parent/Guardian

First Name

Last Name

Parent/Guardian Mobile Phone (Required)

Parent/Guardian Work Phone (Required)

Parent/Guardian Email (Required)

Day Registering For (Required)

Medical Condition (Required)

Please explain Medical Condition

Electronic Signature of Parent or Guardian (Required)

Date

Email Address for Confirmation of Submission (Required)

Online Clubhouse Program Cost

$10.00 per day. Choose box that applies to number of days your are registering for.

10.00
20.00

Your payment will be